If this is your first visit, be sure to
check out the FAQ by clicking the
link above. You may have to register
before you can post: click the register link above to proceed. To start viewing messages,
select the forum that you want to visit from the selection below.

Did you get a letter of medical justification from your provider? While there is no documented evidence that passive standing will help with osteoporosis, there is good evidence for its use to prevent contractures, reduce spasticity (thereby reducing your need for spasticity meds) and improved bowel transit time. You can appeal the decision, and request that your appeal be reviewed by a physiatrist, who is much more likely to know about these benefits (you have the right to request that the appeal review be done by a specific type of specialist, not just a clerk, nurse, or generalist physician).

Did you get a letter of medical justification from your provider? While there is no documented evidence that passive standing will help with osteoporosis, there is good evidence for its use to prevent contractures, reduce spasticity (thereby reducing your need for spasticity meds) and improved bowel transit time. You can appeal the decision, and request that your appeal be reviewed by a physiatrist, who is much more likely to know about these benefits (you have the right to request that the appeal review be done by a specific type of specialist, not just a clerk, nurse, or generalist physician).

(KLD)

Here's what the doctor wrote and also what the insurance wrote to me.Please let me know your thoughts

That is not much of a LMN -- very vague, no citations, multiple misspellings. If necessary, draft an enhanced one yourself citing available literature and have your MD sign. EasyStand may have some examples, but don't copy. KLD said it all as far as the appeal process.

I submitted two LMNs and 9 (yes, NINE) peer-reviewed papers on why dynamic standing frames (EasyStand Glider) help with blah blah blah and my insurance denied it and denied the appeal stating BOTH TIMES that "there is no evidence that static standing frames prevent bone density loss."

i.e. they focused on only one benefit and ignored the fact that it was not a static standing frame.

Private for-profit insurance has no incentive to help chronically injured people. We're just loss centers. Their best case scenario is we die.

I think part of the problem is the piss-poor justification letter you got from your physician. Look at the attachment above. Their letter needs to address in detail and with great specificity each of the required criteria listed, individualized for you.